Quality Consultant or Senior
Quality Consultant or Senior
Bring your experience to a role where you will:
- Develop and implement quality improvement programs related to clinical quality and member experience measures and outcomes, and assist in resolving deficiencies that impact plan compliance with regulatory accreditation standards and/or quality measurement.
- Ensure activities meet regulatory requirements of the state or product and reflects Cambia’s quality strategies, approaches and work plans.
Responsibilities & Requirements
At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, and Accountability. These values are not just words on paper - we live them every day.
- Knowledge of quality improvement processes and performance measurement and ability to develop and accomplish clinical quality measurement and/or program activities.
- Demonstrated ability to identify problems, develop solutions and implement a chosen course of action.
- Leadership skills with the ability to direct activities of others both individually and within a project team .
- Ability to organize, plan, prioritize and develop multiple projects within time constraints.
- Strong knowledge and understanding of data integrity/validity standards and significance.
- Ability to perform sound basic quantitative and qualitative analyses and interpretation.
- Knowledge of the healthcare industry, preferably in the managed care market.
- Excellent verbal and written communication skills including ability to communicate effectively across multiple areas and levels.
- Participation in successful NCQA/URAC accreditation process, AND/OR full HEDIS production reporting and continuous process improvement experience preferred.
Additional Minimum Requirements for level Quality Consultant Senior
- Previous participation in successful completion of the NCQA/URAC accreditation process and continuous process improvement experience in an NCQA/URAC setting.AND/OR prior responsibility for annual HEDIS production including audit and medical record collection.
Normally to be proficient in the competencies listed above:
- Quality Consultant would have a bachelor’s degree in business administration or related field and 6 years of progressive experience in health care administration, quality, project management or project support or equivalent combination of education and experience.
- Quality Consultant Senior would have a bachelor’s degree in business administration or related field and 8 years of progressive experience in health care administration, quality, project leader or project support or equivalent combination of education and experience.
Required Licenses, Certifications, Registration, Etc.
- Certified Professional in Healthcare Quality (CPHQ) preferred.
- May require a valid state driver’s license.
Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.
Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 90 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.
If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.
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Cambia Health Solutions, headquartered in Portland, Oregon, is dedicated to transforming health care. We put people at the heart of everything we do as we work to make the health care system better and more economically sustainable for people and their families. Our company reaches more than 70 [...]